Contenido:

FITS

It is a violent and involuntary muscle contraction, in a continuous or intermittent manner. It may be secondary to a disease (epileptic fit), lack of oxygen (anoxic fit during a syncope), toxics (for example, strychnine or alcohol intoxication), etc.

EPILEPSY is a chronic neurological condition characterized by muscle convulsion with partial or complete consciousness loss. The attacks are brief (several seconds), repeat suddenly with irregular intervals and are usually followed by a few hours of confusion, stupor or deep sleep.

An epileptic may suffer an attack at any time. The patient shouts strangely and suddenly, and falls, with a risk of trauma (wounds, contusions, fractures). His body becomes rigid for a few seconds, he stops breathing and his face turns bluish or pale. This attack phase is followed by spasmodic generalised body fits, with arms, legs and headshakes, face contortion and foam comes out of his mouth. The eyes may move within the orbits, but have no sensibility, and may be touched without any patient reaction. He may bite his tongue or cheeks, staining the foam coming out of his mouth with blood. Micturition or defecation may occur. After a few minutes, the attack usually stops. The patient may recover consciousness or fall into a deep sleep, which sometimes lasts for a few hours. After waking up, he feels confused and is bad tempered; he probably will not recall the attack.

The crisis' treatment must be the same regardless of the cause: during the attack witnesses should avoid the patient getting injured; his movements should not be fully restricted unless there is a risk of falling from a height or dangerously hitting himself.

The management is as follows:

1. Carefully place something between the teeth to avoid tongue biting. A twisted handkerchief or a pencil wrapped in a cloth may be useful. Do not use hard objects, which may cause dental lesions.
2. Place clothes or a pillow under the head, and cover the arms and legs with a blanket to avoid injuries. Tight clothes should be loosened.
3. Do not give medication by mouth.
4. Put to bed after the attack, covering him up if necessary until he is comfortable.

Artificial breathing will not be required, since the phase in which the patient does not breath is very short.

Occasionally, the patient may start to go from an attack to the Siguiente before recovering consciousness in the interval. This situation, called STATUS EPILEPTICUS, poses a serious life risk. Ask for MEDICAL ADVICE VIA RADIO , and in the mean time give an ampoule (10 ml.) of diazepam (DRAWER 4, first aid kits A, B, and C) intramuscularly, or even better, rectally as an enema, using a syringe without a needle, repeating the dose after five minutes if the crisis has not stopped, you can even continue with the same dose every ten minutes up to four or five times.

After the attack, the patient must follow a series of rules:

• Normal diet, except for alcoholic beverages, which should be completely avoided.
• Regular and enough sleep (at least eight hours).
• An epileptic subject is dangerous for on board work, so evacuation must be arranged. If a person suffers from epilepsy any on board work should be discouraged.